左心室和心室逆向重塑在心房移除后在患有缩功能障碍的患者中的临床影响
Masato Okada1, Nobuaki Tanaka1, Yasushi Koyama1
1Cardiovascular Center Sakurabashi Watanabe Advanced Healthcare Hospital Osaka Japan.
Journal of the American Heart Association
|February 11, 2026
概括
对心房动 (AF) 的导管切除改善了心脏功能,但左心房 (LA) 和左心室 (LV) 的综合作用逆转了重塑影响结果. 评估LA反向改造 (LARR) 和LV反向改造 (LVRR) 都有助于风险分层.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏成像 - - 心脏成像
背景情况:
- 对于心房动 (AF) 的导管切除有效地促进左心房 (LA) 和左心室 (LV) 的逆重塑在患有缩功能障碍的患者.
- 在LA逆改造 (LARR) 和LV逆改造 (LVRR) 之间的相互作用以及它们在切除后的临床意义仍然不完全理解.
研究的目的:
- 为了研究AF切除后LARR和LVRR之间的关系.
- 确定LARR和LVRR联合对临床结果的影响,包括AF复发和主要心脏不良事件.
主要方法:
- 对620名患者的评估,基线LV射出分数<50%,接受AF切除.
- 多检测器计算机断层扫描用于评估LA和LV末缩体积在基线和3个月后的消去.
- LARR和LVRR分别定义为LA和LV末缩体积≥15%的减少;临床结果追踪了50.4个月.
主要成果:
- 关节切除显著降低LA和LV末缩体积 (分别为24%±16%和39%±24%,r=0.54,P<0.001).
- 没有LARR和LVRR的患者 (LARR-/LVRR-) 的AF复发率最高 (50.0%) 和复合结局 (25.6%).
- 没有LARR和LVRR (LARR-/LVRR-) 和没有LARR与LVRR存在 (LARR+/LVRR-) 独立地与不良临床结果相关.
结论:
- 在患有缩功能障碍的患者中,AF切除后,LARR和LVRR具有中等相关性.
- 对LARR和LVRR的综合评估提供了不同的废除后轨迹.
- 这种综合评估可能会增强接受AF切除的患者个体风险分层.
相关概念视频
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
607
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
607
Amyloid Fibrils
12.0K
Amyloid fibrils are aggregates of misfolded proteins. Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils.
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
12.0K
Amyloid Fibrils
6.5K
6.5K
Nucleosome Remodeling
11.3K
Nucleosomes are the basic units of chromatin compaction. Each nucleosome consists of the DNA bound tightly around a histone core, which makes the DNA inaccessible to DNA binding proteins such as DNA polymerase and RNA polymerase. Hence, the fundamental problem is to ensure access to DNA when appropriate, despite the compact and protective chromatin structure.
Nucleosome remodeling complex
Eukaryotic cells have specialized enzymes called ATP-dependent nucleosome remodeling enzymes. These enzymes...
Nucleosome remodeling complex
Eukaryotic cells have specialized enzymes called ATP-dependent nucleosome remodeling enzymes. These enzymes...
11.3K
Fibril-associated Collagen
3.4K
Fibril-associated collagens are a type of collagens present in the extracellular matrix with interrupted triple helices or FACIT (Fibril-associated collagens interrupted triple-helices). FACIT help connect and attach the collagen fibrils with each other as well as with other proteins of the extracellular matrix.
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
3.4K
Bone Remodeling
40.5K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
40.5K


